Design and Rationale of the Cognitive Intervention to Improve Memory in Heart Failure Patients Study. Issue 4 (July 2018)

• Record Type: Journal Article
• Authors: Pressler, Susan J.; Giordani, Bruno; Titler, Marita; Gradus-Pizlo, Irmina; Smith, Dean; Dorsey, Susan G.; Gao, Sujuan; Jung, Miyeon
• Is Part Of: Journal of cardiovascular nursing. Volume 33:Issue 4(2018)
• Publication Date: 2018-07
• Subjects: apolipoprotein (APOE)-ε4 -- brain-derived neurotrophic factor -- cognitive dysfunction -- computerized cognitive training; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Heart -- Diseases -- Nursing -- Periodicals; Heart -- Diseases -- Prevention -- Periodicals; 616.10231
• DOI: 10.1097/JCN.0000000000000463
• Languages: English
• ISSNs: 0889-4655

Abstract

Abstract : Background: Memory loss is an independent predictor of mortality among heart failure patients. Twenty-three percent to 50% of heart failure patients have comorbid memory loss, but few interventions are available to treat the memory loss. The aims of this 3-arm randomized controlled trial were to (1) evaluate efficacy of computerized cognitive training intervention using BrainHQ to improve primary outcomes of memory and serum brain-derived neurotrophic factor levels and secondary outcomes of working memory, instrumental activities of daily living, and health-related quality of life among heart failure patients; (2) evaluate incremental cost-effectiveness of BrainHQ; and (3) examine depressive symptoms and genomic moderators of BrainHQ effect. Methods: A sample of 264 heart failure patients within 4 equal-sized blocks (normal/low baseline cognitive function and gender) will be randomly assigned to (1) BrainHQ, (2) active control computer-based crossword puzzles, and (3) usual care control groups. BrainHQ is an 8-week, 40-hour program individualized to each patient's performance. Data collection will be completed at baseline and at 10 weeks and 4 and 8 months. Descriptive statistics, mixed model analyses, and cost-utility analysis using intent-to-treat approach will be computed. Conclusions: This research will provide new knowledge about the efficacy of BrainHQ to improve memory and increase serum brain-derived neurotrophic factor levels in heart failure. If efficacious, the intervention will provide a new therapeutic approach that is easy to disseminate to treat a serious comorbid condition of heart failure.